Bar-Codes Reduce Hospital Errors

A new bar-code system tied to a patient's electronic medical record (EMR) may help hospitals cut down on medication errors.

A team of researchers at Brigham and Women’s Hospital in Boston report that that using a new bar-code scanning system to help administer medications to hospital patients may be the way to go to cut down on medication errors. Nurses who were part of the research team shadowed hospital nurses, tracking the number of errors made both before and after the new method was instated.

The nurse scans bar-codes on the patient’s wristband and on the medication – if there is a match, the patient’s electronic record automatically records that the medication was administered. If there is a mismatch, however, a warning is sent out by the system.

The system, called bar-code electronic medication-administration system (bar-code eMAR), uses the wristbands the patients wear to double-check the medication’s dose and timing before it’s administered. The nurse scans bar-codes on the patient’s wristband and on the medication – if there is a match, the patient’s electronic record automatically records that the medication was administered. If there is a mismatch, however, a warning is sent out by the system.

The research team observed 6,723 medications administered before and 7,318 after the system was implemented. They classified errors as being nontiming- or timing-related. Nontiming errors, as one might guess, were all errors that did not have to do with the timing of the medication – for example, administering the wrong medication, wrong dose, or using the wrong method of administration, fell into this category.

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Before the bar-code eMAR system, the researchers found that the nontiming error rate was 11.5%. After the system was implemented the error rate fell to 6.8%, which represents a reduction of 41%. The researchers also monitored how many “potentially adverse drug events,” ranging from significant to serious, were made before and after implementation of the system: the number of these errors fell from 3.1% to 1.6%, which is a 51% drop. The number of potentially fatal errors did not change significantly after the system was administered.

Errors due to timing also fell, but not so drastically: before use of the bar-code eMAR, the rate was 16.7% and after its implementation the number was 12.2%, which translates into a 27% drop.

The authors conclude that “[u]se of the bar-code eMAR substantially reduced the rate of errors in order transcription and in medication administration as well as potential adverse drug events, although it did not eliminate such errors. Our data show that the bar-code eMAR is an important intervention to improve medication safety.”

The researchers write that in their hospital alone, approximately 5.9 million doses are administered every year – and based on the study’s findings, the bar-code eMAR system could lead to a reduction of 95,000 potentially adverse medication errors per year. Hopefully more hospitals will jump onboard with the system as they become aware of its existence and effectiveness.